Muir Wood therapist, David Laing


Teen Drug Detoxification: The First Step in Recovery

Addictive drugs like marijuana, heroin, cocaine, prescription painkillers, and benzodiazepines can cause changes in the wiring of the brain. In time, the brain feels as though it needs those addictive substances in order to survive, and teens who attempt to stop abusing these drugs on their own may find that they’re simply unable to do so.

In the National Survey on Drug Use and Health, only 34.2 percent of teens thought that smoking marijuana once per month was very dangerous, and only 57.4 percent thought that trying heroin once or twice was very risky. Put plainly, these teens are just wrong. Addictive drugs like marijuana, heroin, cocaine, prescription painkillers and benzodiazepines can cause changes in the wiring of the brain. In time, the brain feels as though it needs those addictive substances in order to survive, and teens who attempt to stop abusing these drugs on their own may find that they’re simply unable to do so. Drug detoxification programs can help. Here, the teen will have access to therapies that can soothe both the body and the mind, allowing the teen to stop abusing substances and learn how to pull together a life that’s free of addictive substances.

Smoothing the Transition

Detoxification is a natural process in which the body learns how to function properly in the absence of drugs. The excess substances left in the bloodstream are washed away, and all of the chemical changes that have taken place as a result of the addiction are soothed, calmed, and healed. It’s not considered a treatment for addiction, in and of itself, as a person who passes through detox is likely to retain many of the same cravings for drugs that existed when the process began, but it can help people prepare for the rest of the recovery process. People who continue to take drugs haven’t yet made a commitment to stop, and they may still be sedated, slow and unable to focus. They’ll need clear minds and healed bodies in order to do the work of rehab, and a drug detoxification program prepares them for that work.

The Substance Abuse and Mental Health Services Administration reports that detoxification programs should contain three equally important components:

  • Evaluation
  • Stabilization
  • Transition to rehab

Some teens move through these three phases quickly, spending a week or even less in drug detox before they move on to their drug rehab programs. Other teens need more advanced help, and they may need additional time in detox before they’re ready to move forward.

Evaluation Phase

Different addictive drugs cause different withdrawal symptoms. People who abuse opiate drugs like heroin or prescription painkillers can feel muscle pain and nausea, for example, while people who are addicted to benzodiazepines like Valium can develop paranoia and seizures as they withdraw. In order to determine the proper treatment approach, the teen might be asked to reveal any and all drugs he/she has been taking on a regular basis. Urine tests might also be used here, to ensure that the information provided is accurate and honest.

Medical tests might also be used during the evaluation phase, to help doctors catch medical conditions caused by the addiction. Teens who inject drugs might have infections around their needle marks, for example, while teens who abuse stimulants like Ritalin might be desperately underweight due to the appetite-suppressing action of this drug. Teens might also have abnormalities that can only be found in blood tests. For example, a study in the Journal of Pediatrics found liver abnormalities in 37 percent of adolescent addicts, and these teens were “presumably well” when they presented for evaluations.

Hidden problems like this could derail a teen’s health in the years to come, but they can also make a full recovery from an addiction a bit less likely, as the teen just won’t feel well enough to participate. Dealing with the issues during detox might be vital. Some programs can provide this kind of medical care on-site, but others might ask teens to go through a full health screening with their doctors and tack on that care to the care they receive in the detox facility.

Mental health screening might also be an important part of a thorough evaluation. According to an article in the Journal of Clinical Psychiatry, adolescent drug abuse commonly occurs alongside a mental illness such as:

  • Depression
  • Anxiety
  • Bipolar disorder
  • Conduct disorder
  • Attention deficit hyperactivity disorder

Teens might use drugs to keep these mental illnesses at bay, and when they attempt to stop abusing drugs, the illnesses can make up for lost time and bombard the teen with symptoms. Identifying the issues early could help staff members to provide effective treatments for these issues, so they don’t interfere with a teen’s recovery process.

Stabilization Phase

Once the staff is aware of all of the issues, they can pull together an effective treatment plan. Choosing an appropriate setting for care is often the first order of business. Teens who have relatively mild cases of addiction, and who have addictions to drugs that don’t cause life-threatening complications during withdrawal, may be able to go through the process on an outpatient basis. They’ll lean on their families as they move forward, relying on them to provide comfort and supervision, but they’ll see staff members periodically for medications and monitoring. Not all teens can utilize this form of care, however. These teens might have addictions to dangerous drugs that are hard to overcome alone, and they might have underlying psychiatric or physical health conditions that complicate their recovery. Utilizing an inpatient program might be the best idea for these teens, as they’ll have the around-the-clock care they’ll need to get well.

Typically, teens enter drug detox programs because they’ve developed addictions to marijuana. According to the Office of Applied Studies, in 2008, 263 teens entered treatment programs due to a marijuana addiction. Only 10 entered due to stimulants, and only nine needed help with heroin or opiate addictions. These statistics make it clear that marijuana is a serious issue for adolescents, and as a result, much of the work done in adolescent drug detox focuses on assisting teens as they step away from this drug.

During marijuana withdrawal, supportive care is vital. Teens can display irritability, agitation, and insomnia as their bodies adjust, and while these problems aren’t life-threatening, they can be disconcerting. Rehab programs provide education, reassuring teens that their symptoms will ease as time moves forward. Providing nutritious foods, soothing music or cool, dark rooms can help teens feel calmer and more able to sleep as they allow their bodies to knit back together.

Teens who are addicted to prescription pills may need more than simple supportive care.
Those teens who take Valium or other benzodiazepines, for example, might need to taper their dosages of the drugs quite slowly, allowing their bodies to come off the drugs smoothly without erupting into seizures. Teens who abuse narcotics, including prescription painkillers and/or heroin, might also need medications in order to heal. These drugs can change the chemistry of the brain to such a degree that the user feels absolutely sick without the drugs, and a deep craving to use drugs again might set in and add to the misery. Replacement medications like methadone or buprenorphine can ease these symptoms, and a tapering dose can allow the body to adjust without symptoms of distress.

Transitioning to Rehab

Typically, when the drug detoxification program is complete, the teen has no active drugs in his/her system and isn’t taking medications to keep symptoms of withdrawal under control. There may be important exceptions to this rule, however. According to the National Institute on Drug Abuse, adolescents addicted to opioids benefit from taking medications for up to 12 weeks, and providing medications for this long period of time is associated with much more significant recovery rates than treatment modes that taper medications earlier. For this reason, some teens may still be taking medications when they’re through with drug detox.

To help smooth the transition to rehab, counselors may begin to visit with people in detox, talking to them about the nature of addiction and how the process typically moves forward. They may provide their clients with books, brochures or videos about the nature of addiction, allowing teens to learn more about what to expect and why it might be important. Therapists might also use motivational interviewing techniques to assist teens who might be resistant to drug rehab.

Here, the therapist asks a series of questions, such as:

  • What do you want to do when you’re an adult?
  • How will drugs help you reach that goal?
  • What’s most important to you in life?
  • How do drugs bring you closer to that person or thing?

The therapy isn’t combative, so the teen isn’t likely to feel attacked or punished. Instead, the therapy is designed to make teens really think about why recovery might be positive, and why it might be worth working toward. It’s a method that allows teens to tap into their inner strength, and this could be vital for their recovery.

Some drug detox programs are attached to facilities that also offer drug rehab. If this is the case, therapists can simply transport their clients to the other treatment center and help them to get settled into the new program. If the two programs are offered on different grounds, therapists might physically transport their clients, or they might stay in touch through visits, ensuring that clients are moving forward with their therapy as directed.

If you need a drug detox program for your adolescent boy, we’re here to help. At Muir Wood, we specialize in delivering effective treatments for boys who abuse substances of all sorts. We can provide drug detox services, and then transition your son into our drug rehab facility. It’s a comprehensive type of care, and we’d like to tell you more about it. Please call us or download our admissions packet.

Teen Alcohol Detoxification: The First Step Toward A New Life

While alcohol can be toxic to the cells of the brain, those same cells can also come to depend upon alcohol. They’re accustomed to functioning in the presence of alcohol, and when that substance is removed, it can cause a chain reaction that can be detrimental to the health of the person.

The National Epidemiologic Survey on Alcohol and Related Conditions determined that people who begin drinking before age 15 are four times more likely to develop alcohol dependence than people who started drinking when they were 21 or older. It’s clear that, when it comes to alcohol, it’s best for parents to discourage their children from experimenting at all. However, even those teens who start drinking early in life can get better and avoid alcoholism, as long as they get treatment for their alcohol abuse and put the lessons they learn in treatment programs to good use as they age. The first step in treatment for an alcohol abuse problem is detoxification, and this article will outline how common detox programs work.

Alcohol and the Brain

When people drink alcohol, they tend to feel the impact of that use almost immediately. They feel more relaxed, more conversational, and less inhibited. After a few hours, the effects seem to fade, and the person is restored to a more natural state of functioning. However, even though the person might feel as though all is well, the alcohol may have left behind telltale damage within the brain. This damage can be persistent in adults, but a study published in the Annals of the New York Academy of Sciences suggests that the adolescent brain is even more vulnerable to the damage alcohol can do.

The hippocampus, in particular, seems to be more susceptible to the effects of alcohol during adolescence, researchers report, and cells within this portion of the brain can even die during alcohol abuse in adolescence.

While alcohol can be toxic to the cells of the brain, those same cells can also come to depend upon alcohol. They’re accustomed to functioning in the presence of alcohol, and when that substance is removed, it can cause a chain reaction that can be detrimental to the health of the person.

In the early stages of alcohol withdrawal, people can feel:

  • Confused
  • Irritated
  • Sensitive to light and sound
  • Nauseated

As the process moves forward, and more cells within the brain awaken and realize that they have no access to alcohol, more severe symptoms can take hold. People can begin to hallucinate, seeing creatures that don’t exist or hearing voices that no one else can hear. They might become violent and upset, screaming and yelling. Some people even develop seizures during this withdrawal process.

The Kindling Theory

Articles such as one published in the journal Emergency Medical Clinics of North America suggest that seizures during the withdrawal period typically take place in people who have been intoxicated for a long time and who have been through the withdrawal process in the past. This seems to suggest that adolescents might not be at risk for seizures, since it’s not likely that teens could go on a long binge of alcohol without being intercepted by their parents. It’s also unlikely that teens have been through the withdrawal process in the past. There are good reasons to pause here, however, and delve into more detail about how the brain responds during withdrawal.

Research suggests that each time a cell wakes up quickly during the withdrawal process, that cell is damaged just a little bit. It has scar tissue and a hidden vulnerability to future problems. In a person who has been through withdrawal once, then goes back to drinking, and then tries to stop drinking again, that damaged cell could wake up faster, and that could be the spark that starts a seizure in the process. Medical professionals refer to this process as “kindling,” implying that these damaged cells work as fuel for the next fire that takes place when the person attempts to stop drinking.

Teens who do have advanced cases of alcoholism and who go through withdrawal on their own at home could be at incredibly high risk for relapse. They haven’t yet picked up any sobriety skills, and they’re not able to handle the temptation to reach for the bottle when times are tough. These teens could be setting themselves up for future seizures, as each time they move through this cycle, they’re doing damage. A relapse to drinking might be less likely in a formal program, for reasons discussed later in this article. Teens who use this option might be prevented from kindling processes and subsequent seizures.

Additional Concerns

Alcohol detox can also be helpful for teens who are binge drinkers. The National Institute on Alcohol Abuse and Alcoholism reports that young people tend to have about five drinks on each drinking occasion, meaning that these people are drinking huge amounts of alcohol with the express purpose of getting drunk. Teens may simply believe that this is the appropriate way to drink alcohol, and they may have no other frame of reference for how alcohol should be used. Teens who binge on alcohol like this can become so very intoxicated that their minds begin to shut down, little by little. Their breathing slows down to a crawl, as does activity within the brain, and the person might feel a bit cold to the touch. The urge to vomit might still be present, but the person might not be awake enough to deal with a rise of vomit, and choking can occur. Teens can also simply stop breathing.

Some detox programs offer support for people who are in a medical crisis like this, and they offer:

    • Medical monitoring
    • Oxygen therapy
    • IV fluids
    • Vitamin supplementation

If these services are provided in a hospital, the person might be transferred to a detox facility when that person is awake and aware.

Care in Detox

Not everyone needs medications during alcohol detox, so they’re not provided on a routine basis to all clients, but they can be helpful if problems begin to appear. During a traditional alcohol detox program, the person is monitored on a regular basis, allowing doctors to ensure that serious symptoms of brain injury aren’t taking place.

Medical staff members might check the person’s pulse and blood pressure frequently, and ask the person to describe how he/she is feeling. If symptoms of delirium begin to appear, sedatives can be helpful in slowing down the process and ensuring that no seizures take place.

Supportive therapy, including cool and dark rooms and soft, nourishing foods can help people to stay comfortable as their bodies adjust. Walking or stretching might be helpful for some people, while just sitting and relaxing might be more appropriate for other people. Plenty of fluids are provided, to help the alcohol move through the person’s body, and vitamins help to replenish the nutrients that are often flushed out of the person’s system due to chronic alcohol abuse.

Inpatient Benefits

People with serious medical conditions due to alcoholism, as well as those who are at high risk of seizures, often go through the detox process in specialized facilities that offer around-the-clock care. There are some people, however, who can go through this process on an outpatient basis, checking in with their doctors on a regular basis and reporting for treatment immediately if something goes wrong.

Some adolescents could use this program, as long as their parents can be committed to supervising them and ensuring that everything is progressing as it should, but an inpatient program might provide help that an outpatient program cannot.

Alcohol detox is just the first step on a long journey the teen needs to take in order to get well. When the alcohol has been removed from the teen’s body, therapy will be vital and that therapy will help the teen learn how to avoid alcohol-related problems in the future. Therapists often begin to work with clients while they’re enrolled in detox, and the techniques they use could help to ensure a person’s success in sobriety. For example, a study in the journal Research on Social Work Practice found that people who went through alcohol detox and then were provided with therapy sessions right away were more likely to use support groups to maintain their sobriety. Using support groups like Alcoholics Anonymous has been associated with long-term recovery from alcoholism, so this is no small feat.

In a detox program, a therapist might ask the teen to think about why he/she needs to stop abusing alcohol, and what life might be like without alcohol. These motivational interviewing techniques are designed to get the teen to think about recovery and its benefits, and firm up the teen’s resolve to change. Therapists might also provide teens with books, videos and pamphlets that describe sobriety in detail. Once again, this can help the teen begin to think about recovery. When detox is complete, the therapist can also transport the person to the rehab facility, ensuring that there is no gap between the two programs. This could reduce the risk that the teen will relapse when detox is complete.

Finding a Program

Some pediatricians are adept at finding rehab and detox programs, and they work with families to ensure that they get the help they need. Not all doctors know about addictions in teens, however, and they may not know how to help families care for their children. Reaching out to a formal addiction treatment program that specializes in teen issues could be helpful. At Muir Wood, for example, we focus on helping adolescent boys with addictions, and we’re happy to either admit patients or help people find other programs that might help them. Other addiction treatment facilities are often willing to take these same steps. We all want to see adolescents recover, and we’ll do whatever we need to do to make that happen. Please call us if you need help.